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Program Integrity

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Nicole0828

Junior Member
What is the name of your state (only U.S. law)?
North Carolina

I have recieved correspondence from Program Integrity stating that an investigation is underway. They requested my presence for information however I recieved the letter 2 days past the appoitnment day. A lady reached out to me July of last year and asked for my estranged spouses income. I provided that to her in the form of tax returns along with my lease that clearly has my name address and my occupants which are my children. The reason for the investigation according to them is because I failed to submit his income, which I did, 6 Months ago! My question is, what is this program? How does this investigation process go? Will I be penalized for missing the appointment as correspondence went to my mothers address (my previous address, although i provided my current months ago!) And whats the worst that could happen? Lastly, should I consult legal aid of NC to aid me in this process?
 


quincy

Senior Member
What is the name of your state (only U.S. law)?
North Carolina

I have recieved correspondence from Program Integrity stating that an investigation is underway. They requested my presence for information however I recieved the letter 2 days past the appoitnment day. A lady reached out to me July of last year and asked for my estranged spouses income. I provided that to her in the form of tax returns along with my lease that clearly has my name address and my occupants which are my children. The reason for the investigation according to them is because I failed to submit his income, which I did, 6 Months ago! My question is, what is this program? How does this investigation process go? Will I be penalized for missing the appointment as correspondence went to my mothers address (my previous address, although i provided my current months ago!) And whats the worst that could happen? Lastly, should I consult legal aid of NC to aid me in this process?
Here is a link to the North Carolina Office of Compliance and Program Integrity:

https://files.nc.gov/ncdma/Program_Integrity_PCS.pdf

It would be smart for you to consult with an attorney in your area.
 
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Nicole0828

Junior Member
Thank you. That information mentioned medicaid and providers. I feel this would be SNAP. Do you have any other resources? I'm sure I know where the fault lied which is me failing to remove my name from our lease when I left and moved in with my mother. At any rate, I appreciate the advice to obtain legal services.
 

quincy

Senior Member
Thank you. That information mentioned medicaid and providers. I feel this would be SNAP. Do you have any other resources? I'm sure I know where the fault lied which is me failing to remove my name from our lease when I left and moved in with my mother. At any rate, I appreciate the advice to obtain legal services.
The link I provided is the best source for information on program integrity.
 
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commentator

Senior Member
Legal aide would be a wonderful resource for you. They regularly work with people who are involved with this agency and can give you some advice, which would probably be to respond to the agency's requests to the best of your ability and get this straightened up as soon as possible.

Assuming you were receiving some type of needs based assistance and that this investigation is concerning your possibly receiving benefits for which you had provided incorrect information or that they need to verify information for, you need to be talking to the legal aid system and asking them all these bunches of questions : "(How does this investigation process go? Will I be penalized for missing the appointment as correspondence went to my mothers address my previous address, although i provided my current months ago! And whats the worst that could happen?") you don't much have a chance of getting correct answers for from strangers on the internet who know absolutely nothing about your case and do not work with this agency or live in this state.

While you may have provided information about your estranged husband's income back in July you must also remember that they have access to other sources of information and if the information you provided was different from other information they may have come up with through their program's cross matching and income verification processes, they'll need to check on it. And that you didn't 'get the paperwork' requesting information way back when is not going to be a very good excuse for ignoring the notices. Avoiding them does not help anything at all.

Since they are used to working with low income people who do not have the ability to repay large amounts of money back to them, a likely thing they might do is sanction you by making you ineligible for the program for a while if fraud is determined. Paying penalties is also a possibility. But never forget, if it is determined by the agency that you have committed actual public assistance fraud, you could be prosecuted criminally. Do not avoid them, do not lawyer up and refuse to cooperate with them( unless indicted), try to deal with this proactively before it becomes a bigger problem.
 
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quincy

Senior Member
It is also possible that the investigation is based on the agency's concern with your ex-spouse or the provider and not with you or what you reported as income or assets.

If the investigation was spawned by what you reported, it must be shown that any misinformation given by you to the agency was intentionally deceptive or willfully misrepresented, this for any criminal charge of fraud to be supported.

I agree with commentator that one outcome of the investigation, if information provided by you to the agency is determined to be false or misleading, would be that benefits are halted and you are made responsible for paying back any overpayment. Criminal charges seem unlikely.

I also agree with commentator that seeking out legal assistance in your area is wise and is advised. It is generally best to have legal assistance before responding to questions posed by investigators.
 

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